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Listening to the voices of children in foster care: youths speak out about child welfare workforce turnover and selection.

Child welfare workforce turnover rates are estimated to be between 23 percent and 60 percent annually across private and public child welfare agencies (Cyphers, 2001; Drake & Yadama, 1996; Jayaratne & Chess, 1984; Jayaratne, Himle, & Chess, 1991). In New York state (NYS), approximately 60 percent of public child welfare agencies have suffered from high turnover for at least one year since 2000. High turnover is defined as an annual turnover rate exceeding 25 percent. In 2004, the rates of workforce turnover in high-turnover agencies ranged from 27 percent to 94 percent (New York State Office of Children and Family Services Bureau of Training, 2004). Despite the growing literature on the etiology of workforce turnover in child welfare (Annie E. Casey Foundation, 2003; Balfour & Neff, 1993; Barak, Nissly, & Levin, 2001; Child Welfare Training Institute, 1997; Dickinson & Perry, 2002; Ellett, 2000; Ellett & E1lett, 2004; Ellett, Ellett, & Rugutt, 2003; Graef & Potter, 2002; Ireland, Smith, & Thornberry, 2002; Strolin-Goltzman et al., 2008), few studies exist on the effects of turnover.

Turnover of public child welfare workers affects a wide range of children and families; however, foster care youths are exceptionally vulnerable to the activities of public child welfare caseworkers, because caseworkers are responsible for their safety, stability, well-being, and permanence.The few studies that have researched the association between turnover and child welfare outcomes found that when caseworkers leave, it touches the lives of the youths in their care emotionally and physically. For instance, in one study, researchers looked at the influences on multiple foster care placements and found a positive association between the turnover of caseworkers and the movement of youths into foster care (Pardeck, 1984).

Most recently, Flower, McDonald, and Sumski (2005) found that children with more than one worker are almost 60 percent less likely to be placed in a permanent situation within Adoption and Safe Families Act timeframes compared with those with only one worker. There are many reasons this might be so. Perhaps the cases lagged for a period of time during the hiring process, or perhaps information about cases was not recorded thoroughly. Both possibilities would be consequences of diminished human capital resulting from workforce turnover.

Studies have also found that agency investment in workforce standards--including stability and experience of caseworkers, low caseloads, and high frequencies of contact with youths--result in significantly better rates of discharge within the first two years of foster care placement (George, 1990). Shapiro (1976) found that more experienced caseworkers were more likely to discharge youths within the first year of placement. In systems in which turnover is high and the average length of employment is two years, inexperienced workers are the norm (Gansle & Ellett, 2002). Despite the availability of casework services that facilitate safety, permanency, and healthy outcomes, many children may either not be receiving these services and placements or may be getting them much later than they might have if they had been served by stable organizational systems with experienced caseworkers.

All of the aforementioned studies provide some indirect evidence of the negative effects of turnover on children and families in the child welfare system; however, the evidence presented in them is outdated and insufficient. Furthermore, studies publicizing the voices of those who are directly served by the system are nonexistent. Perhaps the best illustrations for understanding the consequences of child welfare workforce turnover come from youths themselves, who either fall through the cracks as a result of systemwide workforce instability or succeed despite the costs of an unstable system. The present study provides new insight into the effects of caseworker turnover by asking consumers of the child welfare system (youths) about their experiences.

Providing consumers with a voice about the events that most directly affect their lives is congruent with the values of the social work profession and is essential in truly grasping the effects of a phenomenon on a population (NASW, 2000). Children placed out of home by public welfare agencies have a significant stake in employment practices and patterns within the child welfare system. In fact, their interactions with caseworkers can be determinant of future life outcomes. Although children are an integral part of the child welfare process, far too often their voices have been absent in discussions about how to improve different aspects of the system. Using youths in the child welfare system as a resource for information on caseworker practices is uncommon; however, youths provide an insider's view of the effects of caseworker turnover that has yet to be heard.

The purposes of this study were threefold: (1) to explore the experiences and opinions about child welfare workforce turnover and retention of youths in the child welfare system; (2) to explore the relationship between the number of caseworkers a youth has had and his or her number of foster care placements; and (3) to harness the suggestions of youths in resolving the turnover problem.

METHOD

The data were collected through focus groups and a small demographic survey. Focus groups are indepth guided discussions used to explore a specific problem or question and are preferable for allowing the expression of participants' priorities (Kreuger & Casey, 2000). Focus groups were conducted with 25 youths in the child welfare system. Data were collected in two focus groups consisting of 12 and 13 participants each. Prior to the focus groups, youth participants filled out a short survey with demographic information that included questions about length of time in the child welfare system, number of placements, number of caseworkers, current placement, race, and age. The focus groups were run by two trained social work researchers with backgrounds in child welfare, group works, and adolescent development. The groups lasted one and one-half hours each. Both youths and their guardians signed consent forms; however, only the youths participated in the focus groups.

Focus groups typically use a questioning route, similar to an interview guide, that should grow directly from the research questions (Stewart &: Shamdasani, 1990).The research team collaborated with youths in the child welfare system to develop the questioning route. A draft of the route was developed and sent to a group of youths in the child welfare system for feedback. Alterations were made according to feedback from the youths, and the final route was approved by researchers and youths. About 10 percent of the youths who participated in the study also participated in designing the questioning route.

The final questioning route consisted of three open-ended questions regarding turnover and retention. The questions follow:

Turnover and Retention

1. For those of you with more than one caseworker, think of the time when you were switched from one worker to another. How did your experience of switching caseworkers affect you?

2. For those of you who did not raise your hands, how would you describe your experience of having one worker?

3. What are your ideas for how to retain workers?

Data were collected by two means (survey and focus groups) to test dependability, or reliability, of the data. Dependability is a criterion used in qualitative research to test consistency in data; the term is analogous to reliability in quantitative methods (Lincoln & Guba, 1985). Two recorders attended the groups and transcribed the discussions. Crosschecks were completed to ensure accuracy of the recordings.

Participants

A convenience sampling plan was used to recruit the youths. As a result, the youths were not representative of the youths in the foster care or child welfare population. The youths in this study were older, overrepresented in independent living situations, and leaders within the state's system. All of the youths in the study were involved in New York state's Foster Care Youth Leadership Advisory Team: Youth in Progress (YIP). YIP was formed in August of 2003 as part of the New York State Office of Children and Family Services response to its child and family services review, with the purpose of organizing access to youth voices across the state. The team comprises youth leaders and their adult mentors from nine regional foster care youth leadership teams across New York state. The mission of YIP is "to enhance and advance the lives of today's and tomorrow's foster care youth by giving them a sense of self and responsibility" (Youth in Progress, n.d.).The team has established several priorities, the first of which is to dispel the negative stereotypes of youths in foster care. The other priorities include addressing family and sibling visitation, increasing youth opportunities to make decisions, and improving available services in and after foster care. This study helps to facilitate attainment of priority 3 for the YIP group, which is to "increase youth involvement in selecting, assessing and retaining service providers."

The demographic survey yielded information on age, race, type and number of placements, and length of time in the child welfare system. The average age of the 25 participants was 17.6 years. The average number of placements, excluding independent riving, was 4.4, with a range from one to nine. The majority of the youths (36 percent) were in an independent living program at the time of the focus groups. Participants reported being in the child welfare system an average of 8.5 years, with a range from four months to 20 years. Forty percent of the participants were African American, 12 percent were Latino, 24 percent reported being of two or more races, and 20 percent were white.

Data Analysis

Content analysis was used to analyze the focus group data. Holsti (1969) defined content analysis as "any technique for making inferences by objectively and systematically identifying specified characteristics of messages" (p. 14). Two researchers separately reviewed the data content and developed preliminary categories and coding structures. Categories were compared with each other to derive a set of coded themes from the data. The two coding structures were then compared; the researchers' coding structures were consistent with each other 75 percent of the time. Following the initial development of coding structures, two members of the research team used these categories to assign specific codes to the data. A third researcher provided an additional validity check when there were disagreements between the two main raters. Interrater reliability was greater than 95 percent. Interrater reliability is an estimation based on the correlation of among two or more raters who code the same dataset and helps to establish the dependability of data (Ebel, 1951). Kolbe and Burnett (1991) stated that interrater reliability "is often perceived as the standard measure of research quality. High levels of disagreement among judges suggest weaknesses in research methods" (p. 248).

LIMITATIONS

This study used a convenience sample of youths involved in the child welfare system. The participants in this study were older, were leaders, and disproportionately represented the independent living population. Despite these limitations, the youths in this study make powerful statements about the effects of caseworker turnover on their lives. Future research should continue to explore the effects of turnover with more representative populations of youths within the child welfare system.

RESULTS

Effects of Caseworker Turnover

Three themes relating to caseworker turnover were identified by the youth focus groups: lack of stability, loss of trust, and second chances. The reasons for the turnover were irrelevant. For instance, some caseworkers were rotated or shifted to a different unit, whereas others left their positions altogether. Regardless of the type of change, the effect of the loss on the youth was similar. The majority of the participants had negative perceptions of losing a caseworker (n = 18); however, three participants said that getting a new caseworker improved their relationships by allowing them to receive a "second chance."

Lack of Stability. Nine participants identified feeling a lack of emotional and physical stability due to the "constant changing of caseworkers." Two participants discussed their observation that the changes in caseworkers had caused delays in securing a permanent placement.

To test this observation quantitatively, a linear regression was performed using number of placements as the dependent variable and number of caseworkers in the past two years as the independent variable. Length of time in the child welfare system was used as a control variable. Results corroborated the youths' assumption by indicating that in this study's sample, with every two additional caseworkers a youth had in the past two years, the number of placements increased by one (p = .041).A visual representation of the results is provided in Tables 1 (showing median numbers of placements) and 2 (showing coefficients).

In addition to describing a feeling of instability and lingering, a majority (n = 15) of youths described the re-traumatization of losing their families that coincided with the loss of a caseworker. One example of such a statement was this:
 It was challenging for me because once you get
 used to one person, then you have to change
 over and over, they are creating an unsafe and
 unstable environment for us especially when
 there is already no stability and permanency
 in our lives.


Several (n = 10) of the youths had the perception that administrative policies within the child welfare agencies mandated that caseworkers should not maintain close relationships with their clients: "Every time a caseworker gets close to a kid, the supervisor takes them away. It is like a close relationship is not allowed or something." Youths' perceptions of this sort point to the fine line in youth culture between the needs of youths to have stable relationships with healthy adults and the maintenance of traditional professional boundaries by child welfare agency administrators and frontline staff.

Loss of Trust. Youths in foster care have histories of unhealthy relationships with adults. The effect of workforce turnover is to once again disrupt the development of healthy nurturing relationships with a caring adult:
 I had a caseworker for two years, from the time
 I entered care. She was the first and last worker
 I liked. It was hard to lose the relationship. She
 had gone the extra mile for me and my siblings.
 She made sure I had clothes, had a visit. The
 next worker was very different, and it affected
 the way I treat all the workers I've had since. It
 affects your ability to trust all workers.


Another participant illustrated a similar sense of loss and closing off."
 I had a deep relationship with one worker and
 could talk with her about everything; she had
 answers about things that were important. When
 she left, I shut down, it wasn't the same, it didn't
 feel right. I didn't talk with her [the new caseworker],
 tried to stay away from her and deal
 with my problems by myself.


This cycle of loss is confusing to the youths:
 When you keep losing caseworkers, it affects
 your ability to tell who you can and can't trust.
 I should be able to trust my caseworker, but
 I can't. How am I supposed to tell who I can
 and can't trust when I am out on my own? For
 instance, people tell me to trust my caseworker
 who is supposed to be trustworthy, but then they
 screw me by leaving. The same people tell me
 not to trust my homies, yet they got my back
 no matter what.


Second Chance with a New Worker. Three of the youths identified a sense of relief when they were assigned a new worker, stating that the change allowed for increased communication, a second chance, or a more open and committed worker. One participant stated,
 The change was new and fresh because things
 were not going so well with my old worker. This
 worker that I got is there a lot more for me and
 helps me. Plus she is a lot easier to get a hold of
 than the other workers.


Another respondent discussed her frustrations with "incompetent, overworked, and inattentive workers" by stating, "My caseworker had too much negative to say and was downin' me. I felt like he tried to discourage me when I was tryin' to better myself. Finally I got a new worker. It is better now." Although only three of the 25 participants identified turnover as a positive experience, their statements are poignant and provide a more holistic picture of the effects of turnover on youths in the child welfare system.

Youth Suggestions for Worker Retention

Youths in the child welfare system hold unique knowledge about and have had unique experiences with the child welfare workforce--resources that have thus far gone untapped.They could serve as a resource for developing solutions to the workforce crisis and minimizing its negative effects on child and family outcomes. This section presents their ideas and opinions about the workforce retention problem and provides suggestions for improvements in the areas of retention of frontline caseworkers. Finally, when changes are inevitable, it provides a map for providing smoother transitions for children in the system.

Retention. Youths suggested many of the solutions to combat worker turnover that have previously been identified in the literature:"increase their pay," "lower their caseloads," "make sure they know what they are in for and committed to working with us," "treat them with some respect," and "select better people."

Making the Transition to New Workers. When turnover is inevitable, it is important to make the transitions transparent and smooth. The participants consistently discussed the value of keeping youths fully informed:
 They should make this a smooth transition, such
 as bringing the new worker with you on several
 occasions with the child. I think the problem
 is that a child cannot adjust to the new worker
 quickly at the last minute, and it may take a lot
 of time before that child opens itself up to that
 worker. Workers who think that the child is not
 opening up to them make wrong assumptions
 about the child.


DISCUSSION

This study attempted to answer two research questions: What are the experiences and opinions of youths in the child welfare system about child welfare workforce turnover and retention? And, among youths in this sample, was there a statistical relationship between the number of caseworkers a youth had had and his or her number of foster care placements? Several themes emerged from the effort to answer these questions, and these are discussed in the following paragraphs.

Regarding the first question, youths discussed the effects of workforce turnover as being a lack of stability; loss of trusting relationships; and, at times, a second chance with a new worker. Although the majority of the youths in this study attached negative experiences to losing a caseworker, they also acknowledged that not all worker turnover is harmful. They indicated that turnover is constructive when they receive a new worker who is able to more effectively meet their needs. The youths emphasized that child welfare agencies need to recruit and retain the "right" workers: those who are dedicated to the work and also have the experience and temperament to provide quality services to youths. This idea is congruent with findings from other workforce studies that have emphasized the effects of turnover (Lawson et al., 2005).

Second, it needs to be acknowledged that youths form bonds with their caseworkers that may be as strong as those they have had with their caregivers. As bonding is an essential element in positive youth development, severing those bonds may harm the well-being of children in care. From this study, a question arises about the utility of the common organizational practice of worker unit rotation, in which workers who are shifted from one unit in a child welfare agency (Child Protective Services, foster care, court, prevention, and so on) will rotate to another unit so that all caseworkers in an agency are trained in all unit practices. Future research may want to consider the effects of caseworker unit rotation on child well-being indicators such as bonding.

CONCLUSION

This study provides evidence of the positive relationship between number of caseworkers and number of placements for the youths in its sample. Currently, more in-depth studies are being conducted that consider the effects of child welfare turnover on federal Child and Family Service Review (CFSR) outcomes (studies are being conducted in Milwaukee and New York state). Such studies may be a vital link in the debate on the importance of child welfare workforce turnover. However, these studies are missing other important information that may not be captured by only investigating CFSR outcomes (such as re-reports of abuse) or length of time in care (such as issues of bonding with healthy adults and thriving in the community). Future research should expand to include real-life practice-oriented outcomes such as whether caseworker retention contributes to positive youth development by providing consistent bonding and mentorship that help pave a prosocial pathway.

Approximately 50 percent of foster care youths are of an age (11 years or older) at which they are capable of providing suggestions and feedback about the issues that directly affect their lives, yet it is a rarity for such opinions to be used sincerely in the effort to achieve real system change. This study attempted to alter this tendency by asking youths in the child welfare system how they are affected by workforce turnover and soliciting their suggestions on addressing the problem.

The preamble of the NASW Code of Ethics states, "Social workers promote social justice and social change with and on behalf of clients" (NASW, 2000), yet in the case of effects ofworkforce turnover on foster care, social work researchers should not forget the importance of the "with." This article concludes with five suggestions for caseworkers, state trainers, local and state administrators, and social work researchers on engaging with youths in relationships that facilitate genuine systems change:

(1) Child welfare caseworkers can develop case plans with their clients, solicit their clients' opinions on what services would be most appropriate, be honest with them about their options, and provide them with support to independently make important life decisions. (2) State agency trainers can use youths as resources to facilitate training in youth culture. (3) Child welfare administrators at the state and local levels can solicit youths' opinions on the causes of and solutions to systemwide problems. (4) Local agency administrators can seek the participation of youths during the selection and recruitment of child welfare caseworkers. (5) Finally, social work researchers can collaborate with foster care youth leaders to develop participatory research designs that investigate the effects of workforce retention on other measures of child well-being such as permanency, bonding, and educational achievement. In sum, child welfare agencies and partnering researchers should be challenged to harness the knowledge and experience of foster care consumers by collaborating with them on the development of interventions and innovations that aim to decrease turnover and ultimately seek to revolutionize systems of child welfare care.

REFERENCES

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Strolin-Goltzman,J. S., McCarthy, M., Smith, B., Lawson, H., Bronstein, L., & Caringi, J. (2008). A comparison study of intention to leave among public child welfare systems with high and low turnover rates. Child Welfare, 87, 125-143.

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Jessica Strolin-Goltzman, PhD, is assistant professor, Wurzweiler School of Social Work, Yeshiva University, 2495 Amsterdam Avenue, New York, NY 10033; e-mail: strolin@ yu.edu. Sharon Kollar, LMSW, is national peer network coordinator, National Child Welfare Workforce Institute, Albany, NY Joanne Trinkle, LMSW,, is senior child welfare education specialist, Albert Institute, Parsons Child and Family Center, Albany, NY. An earlier version of this article was presented at a meeting of the Council on Social Work Education, October 2008, Philadelphia.

Original manuscript received August 4, 2006

Final revision received February 4, 2008

Accepted March 28, 2008
Table 1: Median Number of Placements
for the Sample (N = 25),
by Number of Caseworkers

No. of No. of
Caseworkers Placements

2 5
4 6
6 7
8 8

Table 2: Regression of Number
of Caseworkers on Number of
Placements (N - 25)

Variable B SE t

No. of caseworkers in past year .57 .26 2.21 *
Length of time in Child welfare system .32 .07 4.62 ***
Constant .61 .89 0.69
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Author:Strolin-Goltzman, Jessica; Kollar, Sharon; Trinkle, Joanne
Publication:Social Work
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Date:Jan 1, 2010
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